Chapter 19: Activity and Exercise

The core of this chapter on Activity and Exercise in geriatric nursing centers on the complex physiological requirements for movement—involving the nervous, musculoskeletal, cardiovascular, and respiratory systems—and how normal aging and disease processes affect these functions, potentially leading to issues like decreased agility, dexterity, stamina, loss of muscle mass, and restricted movement from conditions such as arthritis. The nursing process is detailed for managing activity-related difficulties, specifically outlining assessment cues, planning goals, and evidence-based interventions for four key problem statements: Altered Mobility, Altered Activity Tolerance, Altered Oxygenation, and Altered Self-Care Ability (Activities of Daily Living or ADLs, such as feeding, dressing, and toileting). The chapter stresses that physical activity, specifically moderate-intensity aerobic exercise (150 to 300 minutes per week) and muscle-strengthening activities (at least 2 days per week), is vital for maintaining independence, physical health, and psychosocial well-being, but requires primary care provider clearance and an individualized plan incorporating proper warm-up, cool-down, and safety precautions. A significant distinction is drawn between the limiting, lower-expectation custodial focus in nursing care and the preferable rehabilitative focus, which aims to help older adults achieve and maintain their maximal physical, psychosocial, and spiritual health by expecting and encouraging high-level function. Finally, the role of nurses in supporting quality of life is explored through encouraging participation in meaningful diversional activities, modifying environments for safety and energy conservation, and leveraging community or digital resources to combat social isolation.